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Cardiovascular Medicine Flashcards

7 cards from real ITE practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

Read the first 7 Cardiovascular Medicine flashcards as text

  1. A 58-year-old man presents with exertional chest pain. Stress testing shows 2mm ST depression in leads V4-V6 at 5 METs. What is the most appropriate next step?

    Answer: Refer for coronary angiography

    High-risk stress test findings (≥2mm ST depression, low exercise capacity <5 METs) warrant prompt coronary angiography for definitive evaluation.

  2. A 72-year-old woman with atrial fibrillation and a CHA₂DS₂-VASc score of 5 is started on apixaban. Which monitoring parameter is most important at follow-up?

    Answer: Renal function annually or with clinical changes

    DOACs like apixaban are renally cleared, so renal function should be monitored at least annually (or more frequently if declining) to guide dose adjustments.

  3. Which finding on transthoracic echocardiography best distinguishes cardiac tamponade from constrictive pericarditis?

    Answer: Pericardial effusion with right atrial collapse in systole

    Right atrial collapse during systole (and right ventricular diastolic collapse) are hallmarks of cardiac tamponade physiology due to elevated pericardial pressure.

  4. A 45-year-old with hypertrophic obstructive cardiomyopathy (HOCM) has persistent symptoms despite medical therapy. Which intervention is most appropriate?

    Answer: Septal reduction therapy (surgical myectomy or alcohol ablation)

    Septal reduction therapy — either surgical myectomy or alcohol septal ablation — is indicated for HOCM patients with persistent NYHA Class III-IV symptoms despite optimal medical therapy.

  5. A patient with known coronary artery disease develops hypotension and pulmonary edema 3 days after an anterior MI. Echo shows a new VSD. What is the definitive treatment?

    Answer: Emergency surgical repair of the VSD

    Post-MI VSD with cardiogenic shock carries very high mortality and requires emergency surgical repair, often with mechanical circulatory support as a bridge.

  6. A 35-year-old woman on oral contraceptives develops sudden-onset pleuritic chest pain and dyspnea. CT angiography confirms pulmonary embolism. Which anticoagulant is preferred for long-term treatment?

    Answer: Rivaroxaban or apixaban (DOAC)

    DOACs (rivaroxaban or apixaban) are first-line for PE treatment in non-pregnant patients without antiphospholipid syndrome, offering convenience with non-inferior efficacy.

  7. A 66-year-old man with severe aortic stenosis (valve area 0.7 cm², mean gradient 50 mmHg) is asymptomatic. What is the most appropriate management?

    Answer: Watchful waiting with serial echocardiography every 6-12 months

    Asymptomatic severe AS with preserved LV function is managed with close surveillance (echo every 6-12 months) and prompt referral once symptoms develop or LV function declines.